Organization
SEMO PATHOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIRGIT ANN JAMES (HR DIRECTOR)
(512) 238-3100
Entity
Organization
Contact information
Practice address
6 MINI DR, SUITE 102, SIKESTON, MO 63801-5134
(314) 487-9737
Mailing address
PO BOX 163584, AUSTIN, TX 78716-3584
(314) 487-9737
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103863
HEALTHLINK
MO
01
—
105288
BLUE CROSS ALLIANCE
MO
01
—
1728
BLUE CROSS ALLIANCE
MO
Enumeration date
07/18/2006
Last updated
08/22/2020
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